The abundant minor salivary gland tissue in the upper respiratory tract can potentially develop neoplasia the same as the wide spectrum seen in head and neck salivary gland tumors. The most recent (2004) WHO Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart includes a brief section on salivary gland tumors and mentions only mucoepidermoid carcinoma, adenoid cystic carcinoma, myoepithelial carcinoma, epithelial-myoepithelial carcinoma, pleomorphic adenoma, and carcinoma ex-pleomorphic adenoma.12 However, there are reports of other salivary gland tumors in the tracheopulmonary location.
García and colleagues recently described a case of hyalinizing clear cell carcinoma with its defining EWSR1-ATF1 (Ewing sarcoma breakpoint region 1–activating transcription factor 1) fusion transcript.13 Similarly, no tracheopulmonary BCAC cases have been reported in the English-language literature since 2004, when Damiani and colleagues described a case of basal adenocarcinoma of the lung.14 In 2012, Yamada and colleagues reported a case of “basaloid carcinoma with central cavitation,”15 which showed a peculiar immunohistochemical profile similar
to the tumor described in the present article—suggestive of a myoepithelial origin if the morphologic architectural features match.
Salivary gland tumors are prone to manifest the squamous phenotype. Depending on the biopsy modality, these squamous areas (squamous eddies) can be sampled and can lead to the erroneous diagnosis of SCC. However, the histologic features of squamous malignancy are
lacking in these squamous components, and the pathologist should be able to distinguish additional phenotypes that can generate a wider differential diagnosis.
On follow-up, this patient has maintained satisfactory respiratory function. Starting 2 years after the initial resection, he has had annual checkups. Recent imaging and bronchoscopy have revealed tumor recurrence in the same site. Because of the patient’s extensive comorbidities, surgical intervention has been deferred in favor of cryotherapy, a less aggressive therapy.
Author disclosure
The authors report no actual or potential conflicts of interest with regard to this article.
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